Cardiovascular Endocrinology & Metabolism最新文献

Background: Cardiovascular disease (CVD) is the predominant cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. The management of hyperglycemia and prediabetes-associated vascular complications rely on pharmacotherapy and lifestyle intervention strategies. Research investigated the cardio-protective effects of Momordica balsamina in a diet-induced prediabetic rats.

Materials and methods: Prediabetes was induced using a laboratory established protocol in male Sprague Dawley rats. Thereafter, M. balsamina (250 mg/kg) was administered to prediabetic rats once a day every third day in the presence or absence of dietary intervention. Blood pressure and plasma glucose concentration were monitored throughout the study. Blood and tissue were collected for biochemical analysis.

Results: M. balsamina with or without dietary intervention resulted into a reduction in mean arterial blood pressure. In addition, there was a significant decrease in the heart tissue malondialdehyde and increased plasma superoxide dismutase and glutathione peroxidase concentration. Furthermore, there was a decrease in plasma triglycerides, low-density lipoprotein with an increased high-density lipoprotein concentration Lastly, M. balsamina with or without dietary intervention demonstrated a reduced plasma tumor necrosis factor alpha and reduced interleukin-6 concentrations in the absence of dietary intervention.

Conclusion: M. balsamina coupled with or without dietary intervention decreased the risk of developing cardiac injury, thus preventing cardiovascular disease in prediabetes. Therefore, this medicinal plant may be a beneficial therapeutic agent in the prevention of prediabetic cardiovascular complications.

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular and cardiorenal events in people across the spectrum of heart failure. Using proteomics analysis, this study investigated the potential benefits of SGLT2 inhibitors in primary prevention at a protein level in patients without diabetes or heart failure.

Methods: This is a sub-study of the EMPA-HEART 2 CardioLink-7 trial, which randomized people without diabetes or clinically overt heart failure but with risk factors for adverse cardiac remodeling to empagliflozin (10 mg/day) or placebo for 6 months. Blood samples were collected during the randomization visit and at the 6-month follow-up visit for proteomics analysis. Our investigation involved two phases of approach: discovery and verification.

Results: Samples from individuals assigned to empagliflozin (n = 21) and placebo (n = 22) (median baseline N-terminal pro-B-type natriuretic peptide levels: 33.9 and 78.4 pg/ml, respectively) were analyzed. In the discovery phase, 28 of 1622 proteins fulfilled our threshold for being differentially expressed at 6 months. Ten proteins were verified, including calmodulin-like protein 5, desmoplakin, hornerin, peroxiredoxin-2, macrophage colony-stimulating factor 1 receptor, endosialin, high-temperature requirement serine protease A1, immunoglobulin epsilon heavy chain, proteasome subunit beta type-5, and cerebellin-4. Compared to the placebo group, the expression of these proteins from baseline to 6 months was all significantly decreased in the empagliflozin group. Their functions involved ion channel signaling, fibrosis, oxidative stress, inflammation, apoptosis, immune response, proteolysis, and neuromodulation.

Conclusion: Empagliflozin modified multiple biologically relevant pathways in the nondiabetes and non-heart failure setting. These findings should be considered hypothesis-generating and warrant validation in larger, adequately powered studies.

Introduction: A proportion of adrenal adenomata exhibit autonomous cortisol secretion, now termed mild autonomous cortisol secretion (MACS), as defined by post-1mg overnight dexamethasone suppression test (ONDST) cortisol 51-137 nmol/l. Here, we characterized the cardiometabolic profile of MACS.

Methods: Clinical records of 98 individuals with adrenal adenomata were examined. Subcategorization into MACS1 (ONDST cortisol of 50-137 nmol/l) and MACS2 (ONDST cortisol of >137 nmol/l was created to take account of individuals with ONDST cortisol of more than 137 nmol/l and no diagnosis of Cushing's syndrome.

Results: Diagnosis of MACS1 associated with a higher diagnosis rate of cardiovascular disease (CVD) (17.7% MACS1) vs. non-MACS = nonfunctioning adenoma (NFA) (3.7%) (P = 0.009) and higher rates of prescription of lipid-lowering agents (51.6%) vs. (29.6%) (P = 0.01). ONDST cortisol levels in MACS1 patients correlated with a more adverse lipid profile (for higher low-density lipoprotein cholesterol, r ² = 0.404, P = 0.007; high-density lipoprotein cholesterol r ² = -0.346, P = 0.023; for higher serum triglycerides r ² = 0.282, P = 0.02) in spite of higher rates of statin prescribing. There was a gradient of increasing numbers of antihypertensives prescribed, going from non-MACS NFA to MACS1 to MACS2. Dunn's post hoc analysis indicated an overall more adverse lipid profile in MACS1.

Conclusion: The positive direction of associations between serum cortisol and lipid measures highlights that MACS carries a metabolically adverse lipid profile. Diagnosis of MACS was associated with a higher diagnosis rate of CVD and appropriately higher rates of prescription of lipid-lowering agents and a greater number of antihypertensive agents prescribed. The question remains about whether a specific directed treatment of MACS should be offered beyond risk-factor-mitigating management.

Central precocious puberty (CPP) results from premature reactivation of the hypothalamic-pituitary-gonadal axis and is increasingly recognized as a systemic condition linked to cardiometabolic health. Genetic mutations, particularly in imprinted genes such as MKRN3 and DLK1, are major monogenic causes of familial CPP, while rare activating variants in KISS1 and KISS1R highlight the pivotal role of kisspeptin signaling. Neuropeptides, including kisspeptin and neurokinin B, are central to pubertal regulation. Advances in clinical assessment, biochemical markers, pelvic ultrasound, and genetic testing have improved diagnostic precision, though differentiating CPP from benign variants remains challenging. Gonadotropin-releasing hormone analogs remain the gold standard for halting progression and optimizing adult height, while novel neuropeptide modulators show promise. Beyond growth outcomes, accumulating evidence indicates significant cardiometabolic sequelae, underscoring the importance of early, precision-guided intervention. Integrating genomic, neuropeptidergic, and metabolic insights can refine diagnosis, guide therapy, and potentially mitigate lifelong cardiovascular risk in affected females.

Background: The effects of dairy products on type 2 diabetes mellitus (T2DM) are unclear. Some studies have revealed the beneficial effects, whereas others found harmful effects of dairy products on the risk of T2DM. The objective of the present study was to investigate the association of different types of dairy products with risk of T2DM in Iranian adults.

Methods: This cross-sectional study included a total of 4241 individuals. Among these participants, 1804 were diagnosed with T2DM or prediabetes, whereas the remaining 2437 individuals were without T2DM. A validated food frequency questionnaire was used to assess the consumption of different types of dairy products.

Results: A positive association was found between T2DM with dietary intake of milk [odds ratio (OR): 1.16, 95% confidence interval (CI): 1.11-1.23, P = 0.008] and cheese (OR: 1.90, 95% CI: 1.41-2.29, P = 0.001) after adjustment for age, sex, physical activity, BMI, education level, energy, and fat intake. There was no significant association between T2DM and dietary intake of total dairy, yogurt, ayran (yogurt drink), and curd.

Conclusion: A positive association was found between the consumption of some dairy products including milk and cheese and the risk of T2DM. Further longitudinal studies are warranted to approve this finding.

Background: Hypertension is the most prominent and well acknowledged chronic disease in developed countries and is a significant contributor to global mortality. The present study aimed to investigate the association between hypertension and different types of dietary carbohydrates.

Method: This cross-sectional study was conducted on 4184 people aged 35-70, including 1239 patients with hypertension and 2945 subjects with normal blood pressure (BP) in Sabzevar, Iran. The dietary intake data were collected through the administration of a semiquantitative Food Frequency Questionnaire. Utilizing Nutritionist IV software, dietary glucose, fructose, simple sugar, carbohydrate, and galactose consumption were evaluated.

Results: A direct association was found between dietary glucose and BP (odds ratio: 1.02; 95% CI: 1.01-1.05; P = 0.04). This association remained significant after adjusting for age. Further adjustments for education, marital status, job, physical activity, and BMI, and additional adjustments for energy intake did not change the results.

Conclusion: In summary, the present study identified a significant association between hypertension and dietary intake of glucose. Considering that carbohydrates are an essential part of the diet worldwide, these findings can be valuable in formulating dietary interventions for hypertensive patients.

Background: Hypertension (HTN) is a major global public health issue influenced by genetics and lifestyle factors such as diet and psychological stress. Previous research suggests a potential link between HTN and dietary vitamin A intake. This study aims to explore the association between HTN and the intake of various forms of vitamin A.

Methods: This cross-sectional study was conducted on 1239 patients with HTN and 2945 normotensive individuals aged 35-70 years in Sabzevar, Iran. Dietary vitamin A intake was assessed using the Nutritionist IV software and a food frequency questionnaire.

Result: A positive association was found between HTN with total vitamin A intake [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.01-1.05, P = 0.04] and β-carotene intake (OR: 1.03, 95% CI: 1.02-1.05, P = 0.03) after adjusting for age and sex. These associations remained statistically significant after adjusting for physical activity and BMI. The association between HTN and β-carotene intake remained significant after additional adjustment for calorie intake. No significant association was observed between dietary retinol intake and HTN.

Conclusion: Increased dietary intake of vitamin A and β-carotene may be associated with a higher risk of HTN. Further longitudinal studies are needed to confirm these findings and elucidate the underlying mechanisms.

Objectives: Patients with type 2 diabetes mellitus (DM) run lower risk for abdominal aortic aneurysm (AAA, aortic diameter ≥ 30 mm) and its complications. We aimed to evaluate associations between disturbances in glucose metabolism and arterial stiffness, AAA, and abdominal aortic diameter in 65-year-old men.

Methods: Forty-eight 65-year-old men with screening-detected AAA and 115 men with normal abdominal aortic diameter underwent examination of glucose metabolism and arterial stiffness.

Results: Men with AAA had higher BMI, waist-hip ratio (WHR), frequency of DM, haemoglobin A_1c, smoking exposure, and plasma insulin levels at 0, 60 and 120 min during OGTT compared to those without. The increase in p-insulin (P < 0.001) after OGTT was also higher in men with AAA, adjusted for smoking, WHR, and nadir value of p-insulin. In analyses adjusted for smoking, use of lipid-lowering agents, and WHR, the increase in p-insulin at 2-hours (P = 0.006) after OGTT and p-homocysteine were associated with abdominal aortic diameter. There were no differences between groups in aortic stiffness or skin autofluorescence Advanced Glycation End products.

Conclusion: In this population-based study hyperinsulinaemia as a marker of insulin resistance, but not hyperglycaemia or aortic stiffness, was associated with AAA and abdominal aortic diameter in 65-year-old men.